Golledge, Jonathan, Clancy, Paula, Maguire, Jane, Lincz, Lisa, Koblar, Simon, McEvoy, Mark, Attia, John, Levi, Chris, Sturm, Jonathan, Almeida, Osvaldo P., Yeap, Bu B., Flicker, Leon, Norman, Paul E., and Hankey, Graeme J. (2014) Plasma angiopoietin-1 is lower after ischemic stroke and associated with major disability but not stroke incidence. Stroke, 45 (4). pp. 1064-1068.

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Abstract

Background and Purpose: Studies in rodent models suggest that upregulating angiopoietin-1 (Angpt1) improves stroke outcomes. The aims of this study were to assess the association of plasma Angpt1 with stroke occurrence and outcome.

Methods: Plasma Angpt1 was measured in 336 patients who had experienced a recent stroke and 321 healthy controls with no stroke history. Patients with stroke (n=285) were reassessed at 3 months and plasma Angpt1 concentration on admission compared between those with severe and minor disability as assessed by the modified Rankin scale. In a separate cohort of 4032 community-acquired older men prospectively followed for a minimum of 6 years, the association of plasma Angpt1 with stroke incidence was examined.

Results: Median plasma Angpt1 was 3-fold lower in patients who had experienced a recent stroke (6.42, interquartile range, 4.26–9.53 compared with 17.36; interquartile range, 14.01–22.46 ng/mL; P<0.001) and remained associated with stroke after adjustment for other risk factors. Plasma Angpt1 concentrations on admission were lower in patients who had severe disability or died at 3 months (median, 5.52; interquartile range, 3.81–8.75 ng/mL for modified Rankin scale 3–6; n=91) compared with those with minor disability (median, 7.04; interquartile range, 4.75–9.92 ng/mL for modified Rankin scale 0–2; n=194), P=0.012, and remained negatively associated with severe disability or death after adjusting for other risk factors. Plasma Angpt1 was not predictive of stroke incidence in community-dwelling older men.

Conclusions: Plasma Angpt1 concentrations are low after ischemic stroke particularly in patients with poor stroke outcomes at 3 months. Interventions effective at upregulating Angpt1 could potentially improve stroke outcomes.

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